Permit - r,
CITY OF TIGARD •
4 MASTER PERMIT
: COMMUNITY DEVELOPMENT Permit#: MST2020-00072
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 1/5 2d 4/ Date Issued: Mar 17 2020 12:00AM
Parcel: 1 S 134BD12700
Jurisdiction: Tigard
Site address: 10914 SW TEAL CREST PL
Subdivision: SUMMERBROOK SUBDIVISION Lot: 10
Project: Summerbrook, Lot 10
Project Description: New SF. 8/5/2020: REPRINT permit to add NC and irrigation backflow device.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 3 First: 2009 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 16 Bathrooms: 2 Second: 0 sf Garage: 406 sf Front: 20 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2009 sf Value: $265,806.52 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 1
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp SrvciFeeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alann: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF V B R-3 2009
Owner: Contractor:
WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions)
1111 N POST OAK RD 1905 NW 169TH PLACE SUITE 102 1 Ersn Cntrl 503-639-4175
HOUSTON,TX 77055 BEAVERTON,OR 97006
PHONE: 503-213-4415 PHONE: 503-213-4415
FAX:
Total Fees: $35,063.77
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2332.19887/7, e1foor 1.800.332.2344.
Issued By: ,4' v " l �--1-1 Permittee Signature: a/xi ' M-i —!7d k/
/Call 503.639.4175 by 7:00 a.m,for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApnlicatioipEcE FOR OFFICE USE ONLY
Cityof Tigard
E Received / .ram 7 ft
g DateBy: �/�/� Permit Nus r !.v�i�/��V "
13125 SW Hall Blvd.,Tigard,OR 97223 I I q Plan Review //
IPI _ Phone: 503.718.2439 Fax: 503.598.1960 O 5 2OCOther Permit:
Date/By:
TIC AHD Inspection Line: 503.639.4175 CITY F Date ReadylBy: lent: El See Page 2 for
Internet: www.tigard-or.gov gUILDIf°G DIVIS TIGA ION Notihed/Method: Supplemental Information
Print name:Michele Schiedler
TYPE OF WORK
® New construction ❑Addition/alteration/replacement COMMERCIAL FEE*:SCHEDULE — USE CHECKLIST
❑ Demolition ❑Other: Mechanical permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead,and profit.
ElI-and 2-family dwelling ❑Commercial/industrial IDAccessory building Value:$
0 Multi-family ❑ Master builder ❑Other. ; RESIDENTIAL.EQUIPMENT/SYSTEMS FEES*
For special information use checklist.
JOB SITE INFORMATION AND LOCATION Description --- Qty. a. Total
Job site address:10914 SW Teal Crest Place eating/cooling:
City/State/ZIP:Tigard/OR/97223 Air conditioning 1 46. 46.75
Pi m:lace_1 nn .$F4f.fdnelslvElnsm 1 46.75
Suite/bldg./apt.no.: Project name:Summerbrook Furnace 100,000+BTU(duets/vents) 54.91
Cross street/directions to job site:SW 120 Ave and Summerbrook Lane Heat pump 61.06
Duct work 23.32
Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Subdivision:Summerbrook Lot no.: 10 Flue/vent for any of above 23.32
Tax map/parcel no.:TBD Other. 23.32
DESCRIPTION OF WORK Other fuel appliances:
Water heater I 23.32
ADD AC TO EXSISITING PERMIT MST202010041— (J 00 7 2 Gas fireplace/insert I 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
® ;PROPERTY OWNER 0 TENANT
Chimney/liner/flue/vent 23.32
Name:David Weekley Homes Other: 23.32
Address: 1905 NW 169th Place,Suite 102 Environmental exhaust and ventilation:
Range hood/otherkitchen
City/State/ZIP:Beaverton/OR/97006 equipment 1 33.39
Clothes dryer exhaust I 33.39
Phone:(503)213-4415 Fax:( ) Single-duct exhaust(bathrooms,
® APPLICANT ® CONTACT'PERSON toilet compattments,utility rooms) 3 23.32
Attic/crawlspace fans 23.32
Business name:David Weekley Homes Other: 23.32
Contact name:Michele Schiedler Fuel piping:
Address:1905 NW 169th Place,Suite 102 $14.15 for first four;$4.03 for each additional
Furnace,etc.
City/State/ZIP:Beaverton/OR/97006 Gas heat pump
Phone:(503)213-4415 Fax::( ) Wall/stlspended/unitbeater
Water heater
E-mail:mschiedler(kdwliomes-cum Fireplace
CONTRACTOR Range
Barbecue
Business name: David Weekley Homes Clothes dryer(gas)
Address: 1905 NW 169'Place Suite 102 Other:
City/State/ZIP:Beaverton/OR/97006 MECHANICAL PERMIT FEES*
Subtotal
Phone:(503)213-4415 Fax:,( ) Minimum permit fee($90.00)
CCB lie.:213653 Plan review(25°/a ofper mkt fee)
j State surcharge(12%ofpemilt fleece))
r d 1�� TOTAL PERMIT FEE
Authorized signature: D t �j
This permit application expires if a permit is not obtained within 180
lir,
J days after it has been accepted as complete.
I:'euildinsPomitu''.MEC PemnUpp 040113.doe 440-4617T(1 I'O2 COMAVEBI
Plumbing Permit Application RECEIVE
Building Fixtures
Cityllimilizmilasiiimi
of Tigard AUG Q 5 2020 Received
Dato/fty: 6/J/24.1 6 Permit Notts-s t ;20- )7.2• 13125 SW Hall lig Blvd.,Tigard,OR 97223
1 Phone: 503.718.2439 Fax: 503.598.I960CITY OF TIGARD Plan Review
Date/By: Other Permit No.:
I I .
Inspection Line: 503.639.4175 BUILDING DIVISION pateReadyBy_ Ada; ® see Page 2for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF.WORK FEE*-SCHEDULE
®New construction 0 Demolition For special information use checklist
Description I Qty. I Ea I Total
0 Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® m
1-and 2-family dwelling ❑Comercial/industrial SFR(2)bath 1 437.78 437.78
❑Accessory building El Multi-familySFR(3)bath 500.32
r Each additional bath/kitchen
1 El Master builder 0 Other: _
Fire sprinkler( sq.ft.) Page 25.02
2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:10914 SW Teal Crest Place Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard/OR/97223
Footing drain(no.linear ft.:230) Page 2 87.55
Suite/bldg./apt.no.: Project name:Summerbrook Manufactured home utilities 50.03
Cross street/directions to job site:SW 121"Ave and SW Summerbrook Lane Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:Summerbrook Lot no.:10 ure or item:
Tax map/parcel no.: /725p 7-V 6->ets�lj6 Backflow preventer 31.27 31,27
DESCRIPTION OF WORK valve _ / 12.51
Clothes washer l 25.02 25.02
New Single Family Home 2009 sqft 3 bedroom,2 bath with 406 sqft 2 car Dishwasher 1 25.02 25.02
garage. Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name:David Weekley Homes Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:1905 NW 169"Place Suite 102
Garbage disposal 1 25.02 25.02
City/State/ZIP:Beaverton,OR 97006 Hose bib 2 25.02 50.04
Phone:(503)213-4415 Fax:( ) Ice maker 1 12.51 12.51
® APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name:David Weekley Homes Medical gas(value:$_) Page 2
Primer 12.51
Contact name:Michele Schiedler
Roof drain(commercial) 12.51
Address: 1905 NW 169"Place,Suite 102 Sink/basin/lavatory 4 25.02 100.08
City/State/ZIP:Beaverton/OR/97006 Solar units(potable water) 62.54
Phone:(503)213-4415 Fax::( ) Tub/shower/shower pan 2 12.51 25.02
E-mail:mschiedler@dwhomes.com Urinal 25.02
CONTRACTOR Waterclase[ 2 25.02 75.06
Water heater 1 37.52 37.52
Business name:Malmedal Plumbing Water piping/DWV 56.29
Address:PO Box 207 Other: 25.02
City/State/ZIP:Banks/OR/97106 Subtotal
Phone:(503)324-0759 Fax:( ) Minimum permit fee: $72.50
CCB Lie.:102535 Plumbing Lic.no.:34-276PB Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: /
/1 TOTAL PERMIT FEE
Print name: Date: This permit application expires ifa permit is not obtained within 180 days
CA d 6 r Ala. 1��22 �� after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
t:lBuildinglPennitslPLMU-PermilApp.doe 10/01/09 440-4616T(10/02/COM/WEB)
CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2020-00072
Date Issued: 03/17/2020
T I GA R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1 S1348D12700
Jurisdiction: Tigard
Site address: 10914 SW TEAL CREST PL
Subdivision: SUMMERBROOK SUBDIVISION Lot: 10
Project: Summerbrook, Lot 10
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 3 First: 2009 sf Basement: 0 sf Left: 5 Parking Spaces: 0
Height: 16 Bathrooms: 2 Second: 0 sf Garage: 406 sf Front: 20 Smoke
Yes
Dwelling Units: 1 Third: 0 st Right: 5
Detectors.
Total: 2009 sf Value: $265,806.52 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 2 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 3 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain 0 Storm Sewer: 100
Tubs/Showers: 2 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: Catch Basins: 0
Bcktiw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywall-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 5
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 ' W/Svc or Fdr: 0
Ea add!500 sf: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL•RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System- N Garage Opener: N All Other N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2009
Owner: Contractor:
WEEKLEY HOMES LLC WEEKLEY HOMES Required Items and Reports(Conditions)
1111 N POST OAK RD 1905 NW 169TH PLACE SUITE 102 1 Ersn Cntrl 503-639-4175
HOUSTON,TX 77055 BEAVERTON,OR 97006
PHONE: 503-213-4415 PHONE: 503-213-4415
FAX:
Total Fees: $34,976.39
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Ore law requires ou to foil the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through 52-0 090. Y may ob a y of the rules or direct questions to OUNC by calling 503. .1987 or 1.800.332.2344.
Issued By: Permittee Signature: X6
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. ///
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Buildi, a Permit Application
Residential .! FOR OFFICE USE ONLY
Received
Cityof Tigard Date y. A I.
' o
y 131S W Hal Blvd.,Tigard,OR 9725�. ' e Plan Review irk P 7�//_
1 Phone: 503.718.2439 Fax: 503 598 1960 Date/By: 3 2 7.0 x' /I/ r (/
z
TIGARD Inspection Line: 503.639.4175 Date Ready/By: RI See Page 2 for
Internet: www.tigard-or.gov Notitj9[MMetho / „/ Su Supplemental Information
C(�. /,
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction ❑ Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑ Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. _
el 1-and 2-family dwelling ❑Commercial/industrial Valuation: $ 0 ���
ElAccessory building El Multi-familyNumber of bedrooms: 3
❑Master builder ❑ Other: Number of bathrooms: 2
JOB SITE INFORMATION AND LOCATION Total number of floors: 1 2L 15
Job site address:10914 SW Teal Crest Place New dwelling area: 2009 square feet 2cio 61
City/State/ZIP:Tigard/OR/97223 Garage/carport area: 406 square feet
Suite/bldg./apt.no.: Project name:Summerbrook Covered porch area: X square feet
Cross street/directions to job site:SW 12160 Ave and SW Summerbrook Lane Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision:Summerbrook Lot no.:10 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New Single Family Home to be built-2009 SQFT 3 Bedroom,2 bath with 406 SQ Valuation: $
FT 2 car garage, Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name:David Weekley Homes Type of construction:
Address:1905 NW 169"Place Suite 102 Occupancy groups:
City/State/ZIP:Beaverton,OR 97006 Existing:
Phone:(503)213-4415 Fax:( ) New:
0 APPLICANT or, CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: David Weekley Homes
Structural plan review fee(or deposit):
Contact name:Michele Schiedler
FLS plan review fee(if applicable):
Address:1905 NW 169'Place,Suite 102
City/State/ZIP:Beaverton/OR/97006 Total fees due upon application:
Amount received:
Phone:(503)213-4415 Fax::( )
E-mail:mschiedler r�i,dwhomes.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name.David Weekley Homes Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:1905 NW 169"Place,Suite 102 Solar lnslallalion Specialty Code checklist.
City/State/ZIP:Be e n/OR/97006 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(503)213-4415 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.:2136 3 Total fee due upon application: $201.60
Authorized si atu • This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Mi ele hiedl r Date:2/28/20 *Fee methodology set by TrTCounty Building Industry
Service Board.
I:\Building\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City of Tigard Received
Date'B Permit No.:
'9 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
Phone: 503.718.2439 Fax: 503.598.1960
TIGARD 24-Hour Inspection Line: 503.639.4175 ® Electrical ® Plumbing ® Mechanical
Internet: www.tigard-or.gov ❑ Other
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No NIA
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. N ❑ ❑
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. N ❑ 0
3 Verification of approved plat/lot. N ❑ 0
4 Fire district approval required. Name of district: 0 0
5 Septic system permit or authorization for remodel. Existing system capacity 0 0 ❑
6 Sewer permit. ❑ 0 ❑
7 Water district approval. El 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. N 0 0
9 Erosion control ®plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- N ❑ 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state N 0 0
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot he completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if N 0 0
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals); location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size N 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, N 0 0
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- N ❑ 0
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. N 0 0
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ►1 ❑ 0
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing N 0 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 N
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists N 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. N 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required N 0 El
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or N ❑ 0
architect licensed in Ore:on and shall be shown to be a p plicable to the ,ro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". N ❑ ❑
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. N 0 ❑
25 Building plans shall not contain red lines or tape-ons. `Mirrored"building plans will not be accepted. N El 0
26 "Reversed"building plans must meet criteria outlined in the Pennit&System Development Fees document. N 0 ❑
27 "Drawn to scale"indicates standard architect or engineer scale. N 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard N ❑ 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ 0 N
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ N
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
1:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(I 1/02/COM/WEB)
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
- 'i DateiB Permit No.: ...
ql 13125 SW Hall Blvd.,Tigard,OR 97223' Plan Review
III Phone: 503.718,2439 Fax: 503.598.1960 1 Date'By: Other Penn it:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: r�a
Internet: www.t gatd-or.gov ) Y y' u: See Page 2 for
Notified;Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
New const
ruction permit fees*are based on the value of the work
❑ Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: I0914 SW Teal Crest Place Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP:Tigard/OR/97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Summerbrook Duct work 23.32
Cross street/directions to job site:SW 121't Ave and Summerbrook Lane Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision:Summerbrook Lot no.:10 Other: 23.32
Other fuel appliances:
Tax map/parcel no.:TBD Water heater 1 23.32
DESCRIPTION OF WORK Gas fireplace/insert I 33.39
Flue vent for water heater or gas
New single family home to be built-2009 sqft,3 bedroom 2 bath home with fireplace 23.32
406 sqft 2 car garage Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
ElPROPERTY OWNER ElTENANT Other: 23.32
Environmental exhaust and ventilation:
Name:David Weekley Homes Range hood/other kitchen
equipment I 33.39
Address:1905 NW 169th Place,Suite 102 Clothes dryer exhaust I 33.39
City/State/ZIP:Beaverton/OR/97006 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 3 23.32
Phone:(503)213-4415 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ® CONTACT PERSON Other 23.32
Business name:David Weekley Homes
Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Michele Schiedler Furnace,etc.
Address: 1905 NW 169'Place,Suite 102 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Beaverton/OR/97006 Water heater
Phone:(503)213-4415 Fax::( ) Fireplace
Range
E-mail:mschiedler@dwhomes.com Barbecue
CONTRACTOR Clothes dtyer(gas)
Business name:David Weekley Homes Other.
MECHANICAL PERMIT FEES*
Address:1905 NW 169th Place Suite 102 Subtotal
City/State/ZIP:Beaverton/OR/97006 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)213-4415 Fax:( ) State surcharge(12%of permit fee)
CCB lie.:213653 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature:
* Fee methodology set by Tri-County Building Industry Service Board
Print name:Ken ttman Date:
r:'BairdingTermits,MEC_PennitApp_040113.doc 440-4617T(t I/02iCOM'WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
L\Building\Permits\MEC_PetmitApp_040I 13.doe 2
Electr'cal Permit Application FOR OFFICE USE ONLY
City of Tigard Received
�.. + ,,'� Permit tk;
Date/By:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: S113.718.2439 Fax: 503548.196(1 Date/By: Related Permit 6:
TIGARD. Inspection Line: 503.639.4175 Ready Date/By: Jens Fd See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
A` "ZtZ1 TAPE OF WORK PLAN]REVIEW 30:vr ik, t + "
E New construction ❑Addition/alteration/replacement Please check all that apply tsubmn 2 wets otplans w5tems checked):
0 Service or Peeler 400 amps or more 0 Building over three stories.
❑ Demolition 0 Other;
where the available fault current 0 Marinas and boatyards.
_. .... 'r° r %..G0. ;'OF.CONS1 RUCJ lON , a a, .*y. exceeds 10,000 amps at 150 volts or 0 Floating buildings.
El 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14.000 ❑Coaunereial-use ag cultural
amps for all other installations. buildings.
❑Multi-fancily ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
t+?, , ' }JOB $ITE:4il11'IFO L&T1oN'.ND LocATION, „ r v ❑Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#:68020010 Job site address: 10914 SW Teal Crest Place I OOFIP or more. ❑"A"."F.","1-Z","I-3",
City/State/ZIP:Tigard/OR/97223 ❑Six or more residential units. oceupancy.
❑Health-care facilities, ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Summberbrook ['Hazardous locations. 0 Supply voltage for more than
['Service or feeder 000 amps or more. 600 volts nominal
Cross street/directions to job site:SW 121st Ave and Summerbrook Lane M`; r e s "" "f"" h ON9 r rF ;%`r=
Description I Qty. I Each I Total 1 '
New residential single-or multi-family dwelling unit.
Subdivision:Summerbrook Lot#: 10 Includes attached garage.
1,000 sq.R.or less I 168.54 168.54 4
Tax map/parcel# TBD
r:'a v ,x,R to _' 2 4 n_K->"1 -v- §3 r -
Ea.add'1500 sq.ft.or portion 3 33.92 107.76 I
s>�� ' ar.,�W:o �+. ;,. -.,,�`,DESCRIPTtON OF•W�RK4 ,�,��,. �,�, =2 , `" �,„_„dAF._:: Limited energy,residential 75.00 2
New single family home to be build-2009 sqft,3 bedroom 2 bath home with (with above sq.ft.)
Limited energy,multi-family 75.00 2
406 sqft 2 car garage residential(with above sq.ft.)
;,"' v s s J Renewable Energy ❑ See Page 2
a.:kwv.v_„ .`a13,RQ1!'E L r; '1VNE(1 - ❑ TENANT,:• • Services or feeders installation,alteration,and/or relocation
Name:David W'eekley Homes 200 amps or less 100.70 2
Address: 1905 NW I69th Place Suite 102 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Beaverton/OR/97006 601 amps to 1,000 amps 301.04 2
Phone:(503)213-4415 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
• relocation
Owner installation:This installation is being made on property that Town which is not 200 amps or less 59.36 1
intended for sale, lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature:__ Date: 401 amps to 599 amps 168.54 2
2klrl'Li601,T r >r < .R
l!1ACTPi RSON
Branch circuits—new,alteration,or extension,per panel
Fw s . ..'.. i e
A.Fee for branch circuits with
Business name:David W'eekley Homes above service or feeder fee, 7.42 2
each branch circuit
Contact name:Michele Schiedler B.Fee for branch circuits without
Address: 1905 NW 1691h Place Suite 102 service or feeder fee,first branch 18 2
branch circuit
City/State/ZIP: Beaverton/OR/97006 Each add'(branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)213-4415 Fax: : ( ) Each manufactured or modular 67.84
dwelling,service and/or feeder
Email: mschiedler@dwhomes.com
Reconnect only 67.84 2
.:.ine,i y r.``..10.0,J`1'1' CTO11. eti .n?.*g'1it«"gin r el ...',.r.<; ;;, Pump or irrigation circle 67.84 2
Business name: Garner Electric Sign or outline lighting 67.84 2
^ Signal circuit(s)or limited-energy
Address: E B 60 Ave . panel,alteration,or extension. ❑ See Page 2[,ry�0 2
'�1^{ 4 y} 2 Each additional inspection over allowable in any of the above
City/State/ZIP:
` ' t k`s 1 i 99..._ ��✓ Additional inspection(I lir min) 66.25/hr
Phone: VC. —r<,Qi kii—LISS ZFax:( ) Investigation(I hr min) 90.00/hr
Email ,,, • rapt ,, r� f p ,jam, Industrial plant(1 hrmin) 78 18/hr
Vl+C1 J@?a 1l3U Vtl C 1 1 ` 6 Inspections for which no fee is
CCB Lie.: I Zl 15�1 Electrical Lie.: � fr S .rv. lc.: 3'h}-S specifically hsted(. hrmm) 9000/hr
Suprv. Electrician signature,required. y Subtotal
Print name:Mal h�t t^ � Date: 2.—7 o—7n 0 Plan Review Required(25%ofpermit fee):
W State surcharge(I 2%ofpermit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within ISO
Print namc:tU IA an, ` g ark Z"t n Date: _1 days after it has been accepted as complete.
r d1 " Number of inspections allowed per petardt
i'.-BuildingPemits'FLt_Penr:itApp_ELR_F.R u. Rev 06 IT2015 440-4615T(11.05-COM WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
-.--
RESIDENTIAL WORK ONLY: FEE SCHEDULE
DocrFee for all residential systems combined: $75.00 vm E�cl� Ib1H1
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
ri Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
FT Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
Garage Door Opener* >100 kva(fee in accordance
with OAR 9 IS-309-0040) 55226 2
® Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
n Vacuum Systems* >100kva--no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
Inspections fnr which no fee is 90.00/hr
specilicallc listed(Y:hr min)
-0I14IMERCIAL WORK ONLY , Eft. i' n .
(Enter
Et . . '
Fee for each commercial system: $75.00 subtotal(Enter on Page 1):
Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
[1 Intercom and Paging Systems
Landscape Irrigation Control*
Ti Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
(1 Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
Id_amilduig.Pemnlls'.El CFern App JUR..ERE.doc Rev 01,17.2015
Pl u,in bi_______u Permit Ayplicatialk�ECE(VED
Building Fixtures 1 oii tttllt i.. ( SI: 0\1.1
FEB 2 7 2020 Received
City of TigardPermit No.:
114 • 13125 SW Hall Blvd.,Tigard,OR 97 lib OF•�'K!_'ARD Plan Re
g `Q1 V t-t Plan Review
Phone: 503.718.2439 Fax: 503.rCJ3 /�'++DIVISION
DateBy: Other Permit No.:
1 I c \lz n Inspection Line: 503.639.4175 INI.DIVISION DateReadyBy: hair ® See Page 2 for
Internet: www.tigardor.gov Notified/Method Supplemental Information
T3PE OF WORK FEE'•SCDULE ,:.. ....
®New construction 0 Demolition Far special information use checklist
Description I Qty. I Ea. . Total
0 Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
. CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
▪ 1-and 2-famil
y dwelling 0 Commercial/industrial SFR(2)bath I 437.78 437.78
❑Accessory buildingSFR(3)bath 500.32
0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:10914 SW Teal Crest Place Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard/OR/97223 Footing drain(no.linear ft.:230) Page 2 87.55
Suite/bldg./apt.no.: Project name:Summerbrook Manufactured home utilities 50.03
Cross street/directions to job site:SW 1219 Ave and SW Summerbrook lane Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:Summerbrook I Lot no.: 10 Fixture or item;
Tax map/parcel no.: Backflow preventer I 31.27 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer I 25.02 25.02
New Single Family Home 2009 soft 3 bedroom,2 bath with 406 soft 2 car
Dishwasher 1 25.02 25.02
garage. Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name:David W eekley Homes Fixture sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:1905 NW 1699'Place Suite 102
Garbage disposal 1 25.02 25.02
City/State/ZIP:Beaverton,OR 97006 Hose bib 2 25.02 50.04
Phone:(503)213-4415 Fax:( ) Ice maker 1 12.51 12.51
. El APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name:David Weeldey Homes Medical gas(value:$_) Page 2
Primer 12.51
Contact name:Michele Schiedkr Roof drain(commercial) 12.51
Address: 1905 NW 1699'Place,Suite 102 Sink/basin/lavatory 4 25.02 100.08
City/State/ZIP:Beaverton/OR/97006 Solar units(potable water) 62.54
Phone:(503)213-4415 Fax::( ) Tub/shower/shower pan 2 12.51 25.02
E-mail:mschiedkr@dwhomes.com Urinal 25.02
Water closet 2 25.02 75.06
CONTRACTOR Water heater 1 37.52 37.52
Business name:Malmedal Plumbing Water piping/DWV 56.29
Address:PO Box 207 Other: 25.02
City/State/ZIP:Banks/OR/97106 Subtotal
Phone:(503)324-0759 Fax:( ) Minimum permit fee: $72.50
CCB Lic.: 102535 I Plumbing Lie.no.:34-276PB C, Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: ,i -'' 1 TOTAL PERMIT FEE
Caro rJ 12 /Lj�l�1�� Date: 2/ /l2b2D This permit application expires if a permit is not obtained within i80 days
Print name: ! after it has been accepted as complete.
'Fee methodology set by Tri-Coimty Building Industry Service Board.
I tkluilding/emitstPL.MU-PemitAppdoc 10/01/09 440-46161110/02'COM/WEB)
City of Tigard
■ 11 COMMUNITY DEVELOPMENT DEPARTMENT
IN
T I c n x D Building Permit Review — Residential
Building Permit #: //5p20 22.,
Site Address: Io N SW 6( 51 f(a(e
Project Name: ,t v...0 k Lot #: [0
Planning Review ff A
Proposal: S j. c lt�n q( p A-
Verify address/suite#active in Accela. n River Terrace: 1CJ No ❑ Yes,River Terrace ReviewAddendxm
Sit Plan Elements: LSE sion Control
1143 copies of site plan on 8-1/2"x 11"or 11 x 17"paper [ pained trees with drip line and tree protection measures
VeDyawn to scale(standard architect or engineer scale) IIGFgotprint of new structure(including decks)and FFE
,
_-W, ,,,1��V orth arrow ty locations&easements(required for new and additions)
itdewD2' i address,project or subdivision name and lot number
alk/driveway approach
plicant information(name and phone number) cation of wells/septic systems
t dimensions and building setback dimensions S eet tree size,type and location
IN •uare footage of buildings to be demolished L�JS t names
fi xisting structures on site IPeomer elevations(2'contours if more than 4'diffe ntial)
pot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? L✓JYes ❑No
un ervious area (applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ❑Y�s 7No
Clean Water Services-Service Provider Letttte/r lot platted prior to 9/10/1995): L, vt)
quired: ❑ Yes,applicant was notified ICY No Received: ❑ Yes D No W'1
R Water Meter Fixture Unit Worksheet-Addiitio�s,Remodels and ADUs tGvyk (/Jr-
Required: ElI(e1 Yes,applicant was notified No Received: ❑ Yes ❑ No
'LI1' SDC Exemption for ADU applied for: ❑ Yes ❑ No Received: ❑ Yes D No
-Public Facilities Improvement(PFI) Permit:
quired: ❑ Yes,applicant was notified ❑ No pplied For. ❑ Yes 0 No,stop intake
Land Use Case#: L` `� O�Otl�- U.' Zoning: 12 41,.S
NA/Required Setbacks: Front: ZL, Rear: I S Side: S. Street Side: j S Garage: 2 0
[ Building Height: Max. Height: 3 a Actual Height: t b
j-Landscape krea: % Lot Coverage M
Entrance back no more than 8'from street-facing wall at Parallel to street or offset 45 degrees or less
Windows ' um 12%of area of all street-facing facades9-24'.
Garage Q'Garx'door is behind widest street-facing wall n Yes 11 No,one of the following is met:
Ed Door extends no more than 5'from wall and there is a covered porch extending beyond garage.
ze-❑ Door extends no more than 5'from w yid there is a 12 sq ft.window above garage on 2nd floor.
_►f Garage door width is 0 12'or less 'k 50%or less of facade 0 60%or less and includes 7 of following:
❑ Covered porch ❑ Recessed entrance ❑ Wall offset 0 1'Roof eave ❑ Roof offset
❑ Fire shingles 0 Lap Siding ❑ Roof pitch ❑ Gable,hip,or gambrel roof ❑ Dormer
❑ Accent siding t, Window trim ❑ Window recess ❑ Window projection 0 Balcony
LV Visual Clearance Ii Urban Forestry_Van
an
�EV, Seensitive Lands: 0 Yes No Type:
t< 'K nddtions met prior to issuance of building permit
No s.: j�
Approved By Planning: - Date: 11-- 7.4
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
I:\Building\Fonns1B1dgPernutRvw_RES_122419.docx
Building Permit Submittal
Original Submittal Date:
Site Plans: #
Building Plans: #
Building Permit#: enter building permit# above.
Workflow Routing: Planning EB E gineering ermit Coordinator ,----fr Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
❑ Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
r
Notes:
By Permit Technician: Date: 7
Engineering Review
c„Conditions
Slope at building pad: Z."Met"prior to issuance of building permit
asements (encroachments)per engineering conditions of approval and plat
lP Water Quality/Quantity Facility: �!
Assess Water Quality Fee in-lieu: El Yes E No
Assess Water Quantity Fee in-lieu: El Yes eNo
LIDA Facility on lot: ❑ Yes 421 No
'Final Plat Recorded:
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: Date: _ l__7 "
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved 0 Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
❑ .DC Exemption: El Received ❑ Does not apply
Fr'SDC Fees Entered: Wash Co Trans Dev Tax: '?es ❑ N/A
Tigard Trans SDC: []7 s ❑ N/A
Parks SDC: [}'Yes ❑ N
O
LIDA 0 Yes /A
K to Issue Permit 2
1247
Approved by Permit Coordinator: /���Date:U/
I:\Building Worms\B1dgPermitRvw_RES_122419.docx